宫腔粘连分离术后使用球囊子宫支架预防再粘连的护理分析.docVIP

宫腔粘连分离术后使用球囊子宫支架预防再粘连的护理分析 　　摘 要：目的 探讨球囊子宫支架用于宫腔粘连分离术后的疗效观察及护理。方法 选取我院2014年7月～2015年6月收治63例宫腔粘连患者行宫腔镜电切分离术后采用球囊子宫支架预防宫腔再粘连，并施行3个月人工周期治疗，术前实施健康知识宣教，术后观察记录患者生命体征及阴道流血情况。结果 宫腔粘连患者术后月经恢复情况，32例恢复正常，15例明显好转，总有效率74.60%。宫腔粘连患者治愈35例，好转15例，总有效率79.36%。结论 球囊子宫支架用于宫腔粘连分离术后预防宫腔再粘连，临床效果安全有效，护理上加强对患者实施积极有效的护理措施及健康教育，严防并发症的发生，是宫腔粘连手术成功的重要保证。 　　关键词：球囊子宫支架；宫腔粘连；宫腔镜电切分离术 　　中图分类号：R473.71 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.02.061 　　文章编号：1006-1959（2018）02-0158-03 　　Abstract：Objective To investigate the curativeand nursing care effect of uterine balloon stents after separation of intrauterine adhesions.Methods From July 2014 to June 2015 in our hospital，63 patients with intrauterine adhesions underwent hysteroscopic resection of the uterine cavity to prevent intrauterine reunion with balloon-shaped uterine stent.The patients were treated with artificial cycle for 3 months.Implementation of health knowledge mission，postoperative observation of patients with vital signs and vaginal bleeding.Results The menstruation of the patients with intrauterine adhesions was recovered after operation in 32 cases and recovered to normal in 15 cases，the total effective rate was 74.60%.35 cases were cured and 15 cases improved.The total effective rate was 79.36%.Conclusion The clinical effect of balloon uterine stents for preventing intrauterine re-adhesion after separation of intrauterine adhesions is safe and effective.It is an important guarantee for the successful operation of intrauterine adhesions to strengthen the positive and effective nursing measures and health education to prevent the occurrence of complications. 　　Key words：Balloon uterus stent；Intrauterine adhesions；Hysteroscopic resection 　　宫腔粘连（Intrauterine adhesions，IUA）是子宫内膜基底层损伤后修复障碍导致宫腔部分或全部粘连的病理现象。有报道IUA已严重威胁女性的生殖健康，其可引起月经量减少、闭经、反复流产、不孕、早产、胎盘粘连或胎盘植入等并发症[1]。宫腔镜下宫腔粘连分离术（TCRA）是直视下有针对性地分离或切除宫腔粘连，能恢复宫腔的正常形态、改善症状和妊娠分娩结局，但并不能修复已被损伤的子宫内膜，且手术创面修复过程中纤维瘢痕形成可致宫腔再次粘连，其术后复发率3.1%～23.5%，重度宫腔粘连复发率则高达20%～62.5%[2-3]。为预防术后再粘连形成，我们采用辅助措施来隔离手术创面